Prevalence of mental disorders by sex among Hera General Hospital patients over the past 10 years

Objectives: Mental disorders manifest as social, occupational, or emotional dysfunctions. Many countries struggle to recognize mental disorders and their effects on communities. Mental health awareness in Saudi Arabia has improved in recent years as psychiatric treatment has become more acceptable in Saudi society. The aim of this study was to determine the percentages of mental disorders among a hospital population at Hera General Hospital, Makkah, Saudi Arabia, using the diagnostic criteria of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders and the tenth revision of the International Classification of Diseases. We aimed to determine sex differences and to identify the five most common disorders. Material and Methods: We identified clusters of mental disorders seen at Hera General Hospital psychiatric clinic using the diagnostic criteria of the DSM-IV and ICD-10 and it was a cross-sectional study of patients at a psychiatric outpatient department from July 2009 to June 2019 in Hera General Hospital, Makkah, Saudi Arabia. Results: The most common mental disorders in patients attending the psychiatric clinic of Hera General Hospital were found to be major depressive disorder (41.3%), followed by anxiety disorders (22.1%), substance-induced psychotic disorder (11.4%), schizophrenia (8.9%), and Mental retardation (7.0%). Females were observed to have a higher risk for mood and anxiety disorders, whereas males had a higher risk for substance-induced psychotic disorder and schizophrenia. Conclusion: Major depressive disorder was the most prevalent mental disorder at Hera General Hospital. Most patients with depressive disorder were female.

Acute inflammatory transverse myelitis post-Pfizer-BioNTech-COVID-19 vaccine in 16-year-old

Coronavirus disease 2019 (COVID-19) originated in China in early March 2019. Saudi Food and Drug Authority approved the registration of the Pfizer-BioNTech COVID-19 vaccine in Saudi Arabia on December 10, 2020, and on May 10, 2021, Pfizer-BioNTech was given an authorized emergency use in 12–15-years-old children. Saudi Arabia’s Ministry of Health started Pfizer-BioNTech COVID-19 vaccination for 12–18-years-old on June 27, 2021. Here, we have a case of a 16-year-old female admitted to the medical ward diagnosed with acute inflammatory transverse myelitis after 2 weeks from second dose of the Pfizer-BioNTech COVID-19 vaccine. The diagnosis was based on normal laboratory workup but significant radiological findings. She was discharged after a full recovery. There are multiple cases of post-vaccine acute inflammatory transverse myelitis shared by medical journals, but due to lack of literature review for the teenager population, we think our case may be the first case of acute inflammatory transverse myelitis following second dose of Pfizer-BioNTech COVID-19 vaccine in this population.

Acute pancreatitis following Pfizer-BioNTech COVID-19 vaccine

The coronavirus disease of 2019 (COVID-19) discovered in China in early December 2019. The Saudi Food and Drug Authority approved the registration of the Pfizer-BioNTech COVID-19 vaccine in Saudi Arabia on December 10, 2020, and on May 10, 2021, Pfizer-BioNTech was given emergency authorization for use of the vaccine in children aged 12 to 15 years. Saudi Arabia’s Ministry of Health started the vaccination phase for ages 12 to 18 years for the Pfizer-BioNTech COVID-19 vaccine on June 27, 2021. An insulin-dependent diabetic 15-year-old female patient admitted to the medical ward diagnosed with acute pancreatitis nine days after being administered her first dose of the Pfizer-BioNTech COVID-19 vaccine. She presented with an amylase level of 340 U/L, lipase level of 937 U/L. She was discharged after eight days of hospitalization with no complications. Medical investigations were unable to link the diagnosis to any known etiology. Medical journals have reported numerous cases of acute pancreatitis in the adult population after Pfizer-BioNTech COVID-19 vaccination. We believe that our case is the first to present with acute pancreatitis after the first dose of the Pfizer-BioNTech COVID-19 vaccine in a teenager population.

An interesting case of duplicated common bile duct and its sequelae

The objective of this case report is to highlight the unusual variant of duplicated common bile duct which has important consequences for future operative planning and subsequent medical surveillance for the patient.

Genome plasticity and its role in leishmania adaptation and drug resistance

Objectives: This literature review aims to summarize the current knowledge regarding the genome plasticity observed within the genome of the Leishmania parasite, and to discuss how genome plasticity contributes to the adaptation of the parasite and to development of a drug resistant state. Material and Methods: The search terms “Leishmania” and “genome plasticity”, were used to search the PubMed database for relevant papers, published between the years 2000 and 2020. Results: Aneuploidy within the Leishmania genome allows for drug resistance and adaptation to the environment. In addition copy number variation promotes the up regulation of genes conferring drug resistant capabilities to the parasite. Conclusion: Drug-resistant Leishmania mutants display differential patterns of chromosomal somy when compared to wild-type strains. Highlighting a role for mosaic aneuploidy in the development of drug resistance. Leishmania parasites in the amastigote life cycle stage display differential gene copy numbers compared to parasites in the promastigote life cycle stage. Suggesting that copy number variation contributes to parasite adaptation to the environment.

A systematic review and utilization study of digital stethoscopes for cardiopulmonary assessments

Objectives: The demand for cardiopulmonary assessment via real-time live streaming is prevalent in remote communities of British Columbia, Canada. Digital stethoscopes enable remote assessments, but the difference in quality compared to conventional assessments is unknown. To explore published literature for real-time remote audio and video streaming of cardiopulmonary assessments via digital stethoscopes, and evaluate the quality of digital stethoscopes for remote cardiopulmonary assessments as compared to conventional stethoscopes in a Cardiac Virtual health Assessments (CaViAs) project. Material and Methods: CaViAs included evaluation of quality and utility of three digital stethoscope devices, three digital platforms/applications, three noise-cancelling headsets, and two Internet-enabled devices with one technical operator and one evaluator. A comprehensive search for “digital stethoscope*” was conducted in PubMed, Science Direct, CINAHL, TRIP, Open Grey and ClinicalTrials.gov in February 2021 for relevant peer reviewed studies. Studies were screened for eligibility and inclusion were screened for eligibility and inclusion based on population, intervention, comparator, outcome and study design criteria and utilizing Preferred Reporting Items for Systematic reviews and Meta-Analysis, and assessed for methodological quality using Critical Appraisal Skills Programme for Randomized Controlled Trials. Studies were eligible if they included adult humans undergoing cardiopulmonary assessment with digital stethoscopes compared to conventional stethoscopes to test the audio quality and ease of use of digital stethoscopes via real-time remote audio and video streaming across a distance. Results: Of 238 articles identified, only one study of poor methodological quality was found that fulfilled all inclusion criteria. This study rated the quality of digital stethoscopes as good or very good. In the CaViAs project, the Eko Duo digital stethoscope in combination with the Eko ECG application, streamed between two Cisco DX 80 devices, and using the Plantronics Voyager 8200 performed the best. Limitations included having only one reviewer for title and abstract screening and data extraction; hearing is subjective; a validated tool for quality testing was not used; and auscultation in general has several limitations. Conclusion: There is a gap in literature to help inform decision-making in choosing digital stethoscopes that are best for real-time virtual remote outreach for cardiopulmonary assessments. For best results, digital stethoscopes should be used in conjunction with equipment that optimize audio and ease of use.

A study on the quality of life among stroke survivors: A cross sectional study

Background: The World Health Organization defines - Health as a “state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Methodology: A cross sectional study on 96 patients with stroke aged more than 30 years was carried out NIMS Hospital, Jaipur for a period of 4 months from 1st January 2018 to 30th April 2018. Results: Out of 96 patients, Mean quality of score of patients with stroke was 65.04±9.982 there was significant difference seen in quality of life score according to sex, side of lesion, duration of stroke, socioeconomic status, occupation and hypertension. Conclusions: It can be said that quality of life is a multidimensional concept. As stroke cases is among the most devastating of health aspect, having multiple and profound effects upon all aspects of life, hence evaluation of quality of life is very important. Each and every effort should be made to improve these aspects and in turn to activity daily living (ADL) and improve the overall quality of stroke patients.

Incidence of Hashimoto Thyroiditis Among Libyans: A Retrospective Epidemiological Study

Background and aims. Hashimoto's disease is an autoimmune disorder in which the body produces antibodies that attack the thyroid gland, leading to chronic inflammation, destruction of the gland, and hypothyroidism. This study aimed to assess the epidemiology of this disease among Libyan patients. Methods. A cross-sectional retrospective study conducted from June 2012 to April 2020 in order to examine the anti TPO level among Libyan population. Data was collected from eastern and western part of Libya, and were analyzed from available sample for 244 apparently patients with thyroid disorders collected from different private clinic’s laboratories. The analysis for serum anti-TPO was done by electrochemiluminescence protein binding assay (ECLIA) using Roche diagnostics and Cobas e411 analyzer. Results. The current results showed that females predominate the study, and most of them were in the age group of (>40) years old. About 49.18% of these cases were suffering from Hashimoto's disease (High ATPO level). The mean value of anti-TPO status among females was (0.5±2) nmol/L, while among males it was (0.45±3) nmol/L. Significantly, more women (81.66%) had Anti- TPO Above (34 IU/ml), compared to (18.33%) of male participants. Conclusion. Hashimoto disease is common among patients with thyroid dysfunction especially females. Our findings suggest that different interventional strategies are needed to reduce the chances of developing Hashimoto’s and its associated negative health outcomes in Libya.

The effect of double-carbapenem therapy on mortality rates and microbiological cure rates in patients diagnosed with carbapenem-resistant Klebsiella pneumoniae infections in comparison to monotherapy and currently used combinations of antibiotics

Introduction: Infection with the bacteria carpamenease-producing Klebsiella pneumoniae represents a significant cause of mortality in hospitalised patients. These multidrug resistant bacteria are resistant to currently used antibiotics as a result of carbapenemase production. Dual carbapenem therapy has been proposed as a valid therapeutic option, this therapy combines two carbapenem antibiotics, with one acting as a suicide inhibitor allowing the subsequent carbapenem to exert a bactericidal effect. Aim: The aim of this meta-analysis was to determine if dual carbapenem therapy had a significant effect on mortality rate and microbiological cure rate in patients diagnosed with carbapenemase-producing Klebsiella pneumoniae infections in comparison to standard antibiotic therapies. Methods: The search terms “(dual OR double) carbapenem (therapy OR treatment) AND klebsiella pneumoniae” were used to search databases and inclusion and exclusion criteria were applied to retrieved papers, a total of seven studies were identified for inclusion in the meta-analysis. The quality of included studies was assessed using the cochrane tool for risk of bias assessment and funnel plots were produced to determine the influence of publication bias. A random effects model was used to assess the outcomes; mortality rate and microbiological cure rate. Results and Conclusion: Dual carbapenem therapy had a time dependent effect on patient mortality rates. Dual carbapenem therapy significantly lowered mortality rates in patients in comparison to standard antibiotic therapy, especially in comparison to monotherapy treatment regimens. Additionally, dual carbapenem therapy significantly improved microbiological cure rate in patients when compared to standard antibiotic treatment regimens demonstrating the possible clinical applications of a dual carbapenem antibiotic regimen in the treatment of carbapenemase-producing Klebsiella pneumoniae infections.